Just How Helpful Are PSA Tests?

It’s said that we all have a cross to bear, and in the health arena, it appears to be true.  Women have mammograms and men have PSA tests, both of which have caused some controversy over the years.  Most recently PSA testing has come under fire, with U.S. Preventive Services Task Force recommending that men not undergo routine PSA screening for prostate cancer.  In addition, in 2010, the American Cancer Society stopped advising routine screening as well and now advise men to confer with their physicians.

PSA stands for prostate specific antigen, a protein produced by the prostate and released into the blood.  While PSA levels can increase due to cancer, they can also be elevated for unknown reasons or from infection or benign enlargement.  Only 20 - 30% of men with high PSA levels have cancer, and perhaps more disturbing is that a similar percentage of men with normal PSA levels do have cancer.

Prostate cancer is unusual in that most of its tumors are small and slow growing, do not spread, and have no symptoms.  This form of cancer is fatal in only about 15% of diagnosed cases.  Men are at increased risk if they are black, over age 60, and/or have an immediate family member with the disease.

The only way to determine if someone has prostate cancer is to do a biopsy, which can cause pain, anxiety, infection, and treatment for a cancer that would never have been life-threatening.   What’s worse is that the standard treatments are surgery and radiation, both of which often cause erectile dysfunction, urinary problems and incontinence.  See why a consultation with your doctor is essential?

My source for this article is the Berkeley Wellness Letter, January 2012.  It’s interesting to note that the Editorial Board for the publication is on the fence with this issue: some will stop having PSA screening, others will continue with some uncertainty, and the rest are undecided.  Even doctors consult their doctors!